Consider TRICARE after retirement
American Forces Press Service
FALLS CHURCH, Va. — Active-duty servicemembers must use TRICARE Prime or Prime Remote, but retirees who are not eligible for Medicare may be eligible for TRICARE Prime or choose TRICARE Standard or Extra.
Each program has advantages pertaining to cost, location and convenience.
If space is available, continuing care in a military treatment facility with a primary care manager through TRICARE Prime requires re-enrolling and paying annual fees of $230 for an individual and $460 for a family. Retirees who choose to enroll in TRICARE Prime at a military treatment facility will receive care based on the same access-to-care standards as all other Prime beneficiaries.
Retirees who move to a location that is not near a military treatment facility, or where Prime is not offered, may find TRICARE Standard or Extra to be the best options. TRICARE Standard is a flexible, affordable plan that gives beneficiaries and their eligible family members a greater choice of providers, no enrollment fees, waiver of cost shares for most preventive health care services and the same low catastrophic cap as TRICARE Prime.
TRICARE Extra offers even lower out of pocket expense if beneficiaries use network providers. Although there is no enrollment fee for TRICARE Standard and Extra, a deductible of $150 for individuals and $300 for a family must be met before cost-sharing begins.
Under TRICARE Standard and Extra, most beneficiaries retain the same access to pharmacy benefits through a local military treatment facility or the TRICARE Mail Order Pharmacy, as well the option to use the TRICARE retail pharmacy network.
Retirees may also be eligible for certain medical and pharmacy benefits from the Department of Veterans Affairs in addition to TRICARE retiree health care benefits. If eligible, members can receive care under either program. For more information, go to http://www.va.gov/health.
The U.S. Family Health Plan is available in six areas of the country for those who enjoyed TRICARE Prime while on active duty. Beneficiaries enrolled in USFHP may not receive care at a military treatment facility or participate in TRICARE pharmacy options, but pharmacy options are a part of USFHP. For more information about USFHP and locations where it is offered, go to http://www.usfhp.com.
The TRICARE Overseas Program Standard option is available to retirees planning to live outside the United States. Retirees and family members must meet a deductible before cost-sharing begins and file their own claims for reimbursement for covered health services.
TRICARE recommends beneficiaries consider all available options and plan well in advance to ensure a smooth transition post-retirement. When choosing TRICARE Prime, be sure to have an enrollment package to the appropriate regional contractor by the 20th of the month before the retirement date or Prime coverage could be delayed.
Always remember to update the Defense Enrollment Eligibility Reporting System with any new personal information, including a new address. Automatic coverage by TRICARE Standard and Extra or TOP Standard occurs after retirement as long as DEERS information is current. It’s easy to do online at https://www.dmdc.osd.mil/appj/bwe/.
Learn more about retiree health care options, including the retiree dental program, online at http://TRICARE.mil/mybenefit or visit a TRICARE Service Center. Contact information and other beneficiary assistance locations can be found at http://www.TRICARE.mil/contactus.